Social Determinants of Health in Ohio
Contents of AHRQ SDOH Database
The Social Determinants of Health (SDOH) database from AHRQ compiles SDOH-related variables across multiple domains from 87 sources including multiple federal and other data sources. The downloadable files contain a total of 675 variables available by year from 2009 through 2020. Data is available across three geography levels: all 675 variables are available by county level, 319 are available by ZIP code, and 321 variables are available by census tract.
These variables are organized into five main categories containing several topics each: social context (demographics, disability, immigration, living conditions), economic context (employment, income, poverty), education (attainment), physical infrastructure (environment, housing, internet, migration, transportation), and healthcare context (characteristics of facilities, characteristics of providers, distance to provider, health insurance status, health outcomes, health care quality, utilization and costs).
SDOH Variables Available at the Census Tract Level
?(caption)
PLACES Data
County Health Rankings Data
Ohio Opportunity Index
The Ohio Opportunity Index (OOI) compiles over 34 variables measuring neighborhood conditions and opportunities, known to be associated with health and well-being, from a variety of domains into a single index score. This index score represents the degree of opportunity available at the Census tract level across Ohio (higher values means more opportunity) and can be used to assess overall neighborhood conditions, target interventions, and adjust evaluations for neighborhood-level risk. It can also be used to learn what types of factors are driving opportunity in specific Census tracts.
The OOI variables comprise seven key domains:
- Transportation
- Education
- Employment
- Housing
- Health
- Access
- Crime
Within each domain, several variables that met validity criteria and were available to cover the entire state at a census tract level were identified. To standardize these variables they were converted into a z-score and some z-scores were reversed in order to make positive and negative values comparable across indicators. Variable z-scores were combined using an unweighted mean and then domain scores were re-standardized to have a mean of zero and a standard deviation of one. For each domain a high score indicates a positive outcome and a low score indicates a negative outcome.
The overall Opportunity Index Score was created by using factor analysis methods to weight the contribution of each domain. Regression methods were used to validate the OOI by testing the association between the OOI domain scores and five health outcomes:
- Pre-term birth
- Child severe mental illness
- Youth asthma
- Life expectancy
- All-cause age-adjusted mortality
Ohio Children’s Opportunity Index
The Ohio Children’s Opportunity Index (OOI) compiles over 54 variables measuring neighborhood conditions and opportunities, known to be associated with health and well-being, from a variety of domains into a single index score. This index score represents the degree of opportunity available at the Census tract level across Ohio (higher value means more opportunity) and can be used to assess overall neighborhood conditions, target interventions, and adjust evaluations for neighborhood-level risk. It can also be used to learn what types of factors are driving opportunity in specific Census tracts.
The OCOI variables comprise eight key domains: access, children health, criminal justice, education, environment, family stability, housing, and infant health. Within each domain, several variables that met inclusion criteria and were available to cover the entire state at a census tract level were identified.
Construction of the OCOI consisted of the following broad steps: 1. Operationalize each measure from original, “raw” data 2. Summarize the measure for each Ohio census tract as a rate, count, or level 3. Standardize each variable, as needed, to yield consistency across measures and domains 4. Synthesize the measures in each domain to create a “domain score” 5. Create an overall Children’s Opportunity Index Score as the unweighted mean of the 8 domain scores
A time varying version of the OCOI (spanning the two periods ending in 2014 and 2017) was created that incorporates 37 of the 53 variables within the same 8 domains.
The OCOI was validated by testing the association of the OCOI and the domain scores with five health outcomes:
- Pre-term birth
- Child severe mental illness
- Youth asthma
- Life expectancy
- All-cause age-adjusted mortality
